OBJECTIVES: The diagnosis of cancer imposes a number of burdens on patients – physical, emotional, and financial. So far, evidence on the socio-economic impact of cancer for patients in Germany is scarce. The aim of the project is to provide an overview of financial losses and risk for poverty in patients with neuroendocrine neoplasms (NEN) and colorectal cancer (CRC) as well as possible psychosocial effects.

METHODS: This prospective quantitative study recruited 249 cancer patients (n=123 NEN/ n=126 CRC) from 11/2016 to 3/2017 at the National Center for Tumor Diseases, University Hospital of Heidelberg. They completed a survey on patients’ income, cancer-related out-of-pocket costs, subjective distress (Distress Thermometer), quality of life (EORTC-LQ 29/30), health status (EQ-5D) as well as demographic data.

RESULTS: Overall, 86.7% (n=216) of the patients reported that their financial situation has deteriorated, due to cancer-related out-of-pocket costs and/or income losses: 82.7% (n=205) stated to have higher out-of-pocket costs because of their disease. Higher cancer-related out-of-pocket costs per month were associated with a lower reported quality of life (.002) and higher distress levels (.02). Using poisson regression, the correlation of the subjective distress with selected items on income and expenditure since diagnosis was examined. Under the control of cancer and the age group, the amount of expenditure due to the disease (.09) as well as the overall worsening of living conditions (.26) have a significantly positive effect on the stress experienced by a patient.

CONCLUSIONS: Although the number of studies investigating the subjective financial burden of cancer patients is constantly rising, this is one of the first studies within the German health care sector. Further research is required to develop both, validated instruments on the subjective financial burden that address health service conditions in Germany and targeted measures that could prevent financial problems and reduce emotional burdens.